In 2019, it’s possible to get medical testing done without stepping foot in an exam room or lab. If you can prick your own finger, you can use an at-home testing kit such as Let’s Get Checked or EverlyWell to check for STDs and other infectious diseases, measure levels of assorted hormones and vitamins, and gather all sorts of diagnostic data. That’s to say nothing of learning about your genome by spitting into a tube and mailing it off.
But how reliable are DIY medical tests? And if you use one, should you still see a doctor to interpret the results? We asked five healthcare providers how at-home testing kits measure up, and what patients should know before cutting the phlebotomist out of the picture. Here’s what they had to say.
Dr. Gary Linkov, MD
Facial plastic surgery and otolaryngology, City Facial Plastics
New York City
At-home medical testing kits have become extremely popular over the past decade. There are many different brands of at-home medical testing kits and they are not regulated by any formal organization. There is no larger agency that regulates the quality control, and there may be significant variability from one brand to another. There also exists variability in collection technique, as people are performing the tests on themselves without any supervision as to whether or not the specimen is collected properly. Additionally, the companies who make these tests are able to charge customers as much as they want, and the customers pay out of pocket for testing without the possibility of being reimbursed by their health insurance.
Another significant concern is that many of these tests have not been scientifically validated. As an otolaryngologist, I see many patients who suffer from sinus and nasal problems related to allergies. I refer many of these patients for allergy testing, where we measure the levels of a type of antibody called immunoglobulin E, or IgE, to various allergens. IgE levels have been scientifically validated by years of research to be an accurate marker of someone’s allergic response. Recently, however, many celebrities and social media influencers have been advertising the Pinnertest, which has been marketed as an at-home food allergy and intolerance testing kit. The Pinnertest measures a person’s levels of a different kind of antibody called immunoglobulin G, or IgG, in response to different foods. Unlike IgE, IgG has absolutely no scientific relationship to food allergies. In fact, in the current state of the medical literature, it is unclear if IgG levels for specific allergens have any clinical significance whatsoever. The Pinnertest costs $490, which is a lot of money to spend on a test that is considered useless by most medical professionals.
One final and very important aspect to consider about at-home medical test kits is what one does with the results. For instance, at-home medical kits may be able to tell you that you have chlamydia, but what now? You will still need to see a doctor in order to get treated and potentially get checked for other sexually transmitted infections. Similarly, at-home tests may suggest that your thyroid is underactive, but you still would need to talk to a doctor about treatment, monitoring and figuring out why your thyroid is not functioning normally.
Dr. Laurence Gerlis, MA, MB BChir (Cantab), MRCP, Dip Pharm Med
I look after a number of patients with type 1 diabetes who need to check their blood glucose regularly — sometimes four to six or more times per day. Over the years, they have done this using blood-testing glucose kits, which enable them to monitor their condition and adjust their diet and exercise and insulin dose. The latest version is a freestyle device whereby an implanted cannula can be read by mobile phone — the cannula needs to be replaced every two weeks, but this is highly sophisticated home testing and many of my patients email me their blood test results so I can manage their condition remotely without needing a face-to-face consultation. From this point of view, home blood glucose monitoring has revolutionized the management of type 1 and type 2 diabetes.
However, a number of patients have tried to do home HIV testing. The problem with this is that the patients are already anxious and any slight mishandling of the test kit or misreading of the result can lead to tremendous anxiety. Even now, we do look after some patients who do home testing for chlamydia and gonorrhoea, but the turnaround time for us to post a kit and for them to send the kit back to us adds to the waiting time. This is enormously stressful, and my general advice is that a test like this should be done at an accredited laboratory with the samples taken by a doctor or nurse.
Dr. Robert Milanes, MD
Aesthetics and family medicine, Luminary MD
My practice currently utilizes home testing kits. We also integrate then with telemedicine. I think that they are a great tool. In the busy world we live in, it only makes sense to leverage technology and tools such as home testing to provide great care. Home testing kits add a nice convenience factor to allow patients to live their lives and take care of their health. Of course, not all kits are built the same.
Dr. Chirag Shah, MD
Co-founder of Accesa Labs
El Segundo, California
At-home testing kits can serve as a nice complement to the existing medical system, as they improve access to diagnostic testing. One of the struggles that many patients have these days is access to a timely appointment with their doctor or medical provider. Rather than wait several weeks for an appointment to get lab testing, patients now have the ability to test themselves and potentially take action toward improving their diet or lifestyle in advance of any medical appointment.
The downside of at-home testing kits is that there is a wide range in quality, and it can be hard for a consumer to distinguish what types of kits are accurate and what types are not. One hybrid model that is becoming more popular is online lab testing services that make it easier to order lab tests online and get tested at the same labs that doctors and medical providers use.
Dr. Anika Ackerman, MD
Urologist at Garden State Urology
Whippany, New Jersey
As a specialist in urology, I have come across many patients with recurrent urinary tract infections who use at-home testing kits to check their urine. In some cases, this may be helpful for a patient who has symptoms. If they feel like they have a UTI and their urine tests positive, then it is a useful preliminary diagnostic tool. However, I have often found that some of my patients will check their urine when they do not have symptoms. If there are any abnormalities in the home test, they become alarmed. The urine tests can produce false positives, which can lead to anxiety in a patient who is perfectly fine. Also, patients may have a few white blood cells in their urine and this can be normal, but will show up abnormal on the home kit and again lead to unnecessary alarm.
Responses have been condensed and lightly edited.